System readiness for midwifery-led models of care in the United Arab Emirates: A SWOT analysis and implications for quality maternity care

BACKGROUND: Midwifery-led continuity of care (MLCC) models improve maternal and neonatal outcomes, women's experiences of care, and health system efficiency. In the United Arab Emirates (UAE), where midwifery is an evolving profession within a rapidly developing maternity system, understanding readiness for MLCC implementation is essential. AIM: To examine the strengths, weaknesses, opportunities and threats (SWOT) associated with implementing MLCC in the UAE and identify implications for maternity care. METHODS: Data were derived from a narrative review of international policy frameworks, national policy and regulatory documents, empirical studies and contextual literature relevant to implementation of MLCC in the UAE. Findings were synthesised using a SWOT framework to identify key system-level factors influencing implementation. RESULTS: Strengths included established maternity infrastructure, growing educational capacity and alignment with international standards. Weaknesses included limited role clarity, variable clinical training capacity and fragmentation across sectors, constraining continuity of care. Opportunities included supportive national policy, strong international evidence for MLCC and expansion of continuity models within community and primary care. Threats included a predominantly medicalised model of care, workforce sustainability challenges and market-driven service delivery. Together, these factors indicate that implementation risks remaining fragmented without coordinated system-level reform. CONCLUSION: The UAE has a strong foundation for implementing MLCC but requires greater role clarity, workforce development and service redesign to realise its benefits. Interpreted through Kingdon's Multiple Streams Framework, the findings suggest that successful implementation will depend on aligning system needs, evidence-informed policy solutions and political support. These findings may inform implementation of MLCC in other rapidly developing maternity systems.